Cost and Early Complication Analysis Following Total Hip Arthroplasty in Parkinson’s Disease Patients: A Propensity-matched Database Study

Document Type : RESEARCH PAPER

Authors

1 Department of Orthopaedic Surgery, Joan C. Edwards school of medicine, Marshall University, Huntington, WV, Huntington, West Virginia, USA

2 University of Calgary, Calgary, Alberta, Canada

3 Department of Orthopedic Surgery, Boston University, Boston VAMC, Boston, Massachusetts, USA

4 School of Medicine, University of Texas medical Branch,Texas, USA

5 Department of Orthopedic Surgery, University of Texas Southwestern, Dallas VAMC, Dallas, Texas, USA

Abstract

Background: Parkinson’s Disease is a well-known neuromuscular disorder, which affects the stability and gait of 
elderly patients. With the progressive increase in the life span of patients with PD, the problem of degenerative 
arthritis and the consequent need for total hip arthroplasty (THA) in this cohort are rising. There is paucity of data in 
the existing literature regarding the healthcare costs and overall outcome following THA in PD patients. The current 
study was planned to assess the hospital expenditure, details regarding hospital stay, and complication rates for 
patients with PD, who underwent THA. 
Methods: We investigated the National Inpatient Sample data to identify PD patients, who underwent hip 
arthroplasty from 2016 to 2019. Using propensity score, PD patients were matched 1:1 to patients without PD by 
age, gender, non-elective admission, tobacco use, diabetes, and obesity. Chi-square and T-tests were used for 
analyzing categorical and non-categorical variables, respectively (Fischer-Exact test was employed for values<5).
Results: Overall, 367,890 (1927 patients with PD) THAs were performed between 2016 and 2019. Before matching, 
PD group had significantly greater proportion of older patients, males, and non-elective admissions for THA (P<0.001). 
After matching, PD group had higher total hospital costs, longer hospital stay, greater blood loss anemia, and prosthetic 
dislocation (P<0.001). The in-hospital mortality was similar between the two groups. 
Conclusion: Patients with PD undergoing THA required greater proportion of emergent hospital admissions. Based on 
our study, the diagnosis of PD showed significant association with greater cost of care, longer hospital stay, and higher 
post-operative complications. 
Level of evidence: II

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Volume 11, Issue 1
January 2023
Pages 47-52
  • Receive Date: 20 April 2022
  • Revise Date: 21 September 2022
  • Accept Date: 22 September 2022
  • First Publish Date: 22 December 2022